Romney’s Wrong: Lack of Health Insurance is Killing Us

In a recent 60 Minutes interview, presidential candidate Mitt Romney suggested the uninsured population in the United States doesn’t need health insurance to access medical care. Romney said, “We do provide care for people who don't have insurance… If someone has a heart attack, they don't sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care.

What Romney overlooked is that care to which he’s referring—emergency room care—doesn’t come cheap. The average emergency room bill came to $1,381 in 2011. That’s a bill the uninsured are expected to pay, and if they can’t, everyone else pays for it when the hospital offsets the loss by charging more from those who can pay.

But Romney’s comment misses the larger point by treating emergency rooms as simply another means of delivering care. In reality, emergency rooms should serve as the last line of defense, not as the primary care facility for a segment of the population. Behaving as though the uninsured have an alternative but sufficient means of health care delivery is simply irrational.

The data clearly demonstrate the uninsured receive inferior care. In their 2012 study Dying for Coverage, Families USA reports, “Across the nation, 26,100 people between the ages of 25 and 64 died prematurely due to a lack of health coverage in 2010. That works out to… 72 people who died prematurely every day.” Of those, 193 were Minnesotans.

Cost concerns make uninsured adults over three and a half times as likely to forgo preventive care and six times as likely to go without needed care. A separate study of ICU patients in Pennsylvania found the uninsured receive less aggressive care and have a higher likelihood of mortality compared to the insured visiting the same ICUs. And the problem isn’t just limited to adults—uninsured children who are hospitalized are twice as likely to die from their injuries, less likely to receive expensive treatment, and are sent home earlier.

Not only are the uninsured receiving inferior care, but they have to pay more for it: Without a health insurer to negotiate a lower payment rate, the uninsured are often billed more than 2.5 times the cost of services billed to a health insurer. Forced to pay more for a lesser product, it’s no wonder the uninsured are 25% more likely to die prematurely.

Furthermore, inferior care for the uninsured doesn’t just hurt them—it hurts everyone. Sarah Kliff reports that in areas with more uninsured patients, even those with insurance receive worse care, as hospitals are forced to spend more on uncompensated care and have less to spend on staff and equipment. She writes, “[I]f uninsurance were eliminated, there would be 3 to 5 percent fewer deaths among those who already had coverage” (emphasis mine).

If the Affordable Care Act continues on its path to full implementation, then the number of uninsured will shrink significantly in 2014, thanks to the expansion of Medicaid, the issuing of health insurance subsidies, and the enforcement of the individual mandate. That will mean better health outcomes for those presently uninsured—but it will also mean better health outcomes for everyone else.

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7 Comments:

norm hanson says:

October 4, 2012 at 6:44 am

ER care is very expensive and should not be seen as essentially a priamry care clinic for the poor and/or uninsured. The ACA, when fully implemented, will reduce the deficit over time and will cut over $700 billion out of Medicare Advantage provider reimbursements, reimbursements that were set at 15-20% over market when the Medicare Advantage plan was adopted by the Republicans. As to whether some folks get inferior care than others, that is kind of a difficult thing to quantify let alone determine. In fact, some folks who get less care from the system may do better or at least as well as those who get too much care, much of it redundant or of questionable value, because their insurance covers it or because they can self-insure. And, of course, there is that old question of what is meant by quality health care? No one wants to receive or provide anything less that high quality health care but everyone appeast to define it differently which makes credible assessments of the quality of ehalth care difficult to make.

I have seen the health care issue as penultimate for some time. Why? It is both a powerful human issue and a competitiveness issue. Oh?
Currently we spend twice as much per capita on health care as all of our global economic competitors. How much do think that hurts our exports?! The response of the business community hasn’t been to press to fix that… but mostly to try and shift costs… to their employees.
So much for Romney’s constant assertion that business just does things better than government. Looks more like they’re just better at “ducking” to me.
And his assumes you have a job to get some coverage. The ACA is a beginning, repeat a beginning, of trying to get our costs in line, while also making coverage near universal. If that doesn’t sound good to you… please, here’s a thermometer to check your temperature. This is one area where normal market forces don’t operate very well. Don’t like the price of a dvd player? You just say “no.” You can live without it… and lots of “no’s
exert market pressure on the price.
Standing in the E.R. with your loved one, how much ability would you have to say “no?” You don’t, and don’t tell me you will, or I will call you a liar!
It’s “funny,” the mandate to make sure everybody was in the insurance pool, to make the math work, was a Heritage Foundation idea 15 years ago… yes, it was a Republican idea. Now they’re against it… this lays bare their brazen obstructionism. The only real question is? Will America take more of this ugly “bait?”
If you read the 2nd Bill of Rights that FDR proposed in 1944… to “win the peace” ... health care was on that list. He died before getting it done. It’s not too late, our great country can still make it all happen!

I wonder how long it will take our government to realize that the number of deaths from lack of access to primary, ongoing health care is far greater than the number of Americans who die from the violence that is war. What makes it worse is that wars are often fought for the financial advantage of oil companies or to hunt down “terrorists who hate our freedoms” and would “do us harm.”

But we gladly spend untold billions on war, causing the deaths of millions of citizens of “enemy” countries or ideologies, while ignoring the number of lives that universal single-payer healthcare would save (while also saving at least $400 billion per year) because, you know, that would be “socialism.”

Actually, the Heritage Foundation lifted the idea for Romneycare from the Swiss, Norwegians and other European countries, all of whom spend far less than we do and all of whom have universal health care.

As could be expected, the Heritage Foundation removed government oversight from a great system and made Romneycare another cash cow for large for-profit providers and for insurance and drug industries.

The European system requires that all insurers be nonprofits. The government studies health care costs each year and tells providers whether or not they can increase their prices. It then adjusts the cost of insurance premiums only enough to cover increases in care costs.

Patients shop the exchange not for price, because all insurers charge the same, but for quality of customer service. The government helps the poor pay the cost of premiums.

Too bad our Congress followed the Heritage route instead of the what-is-best-for-our-people one.